Tuesday, May 19, 2009

Based on Conclusions of New Study, Philip Morris Should be Congratulated for Designing a Safer Cigarette and Should be Allowed to Advertise It As Such

As reported here by the Associated Press, and as discussed earlier on this blog, a new unpublished and non-peer-reviewed study by Dr. David Burns of UCSD has concluded that the observed increase in the risk of adenocarcinoma of the lung among smokers is due to an increased nitrosamine content of cigarettes over time. I reported that this conclusion is little more than speculation and that there are alternative hypotheses for the observed changes in lung cancer risk, such as the introduction of low-yield cigarettes which caused smokers to inhale more deeply, delivering more tar to the distal and more susceptible part of the airway. I also criticized the release of the study's conclusion as an example of science by press release, especially since it was so clearly timed to coincide with the Senate's consideration of FDA tobacco legislation, which the study aims to positively influence. Finally, I showed that the study actually demonstrates the folly of the proposed FDA legislation and shows why the bill would create a situation that perpetuates, rather than ends, the fraudulent deception of American consumers regarding the risks of cigarette smoking and changes in those risks associated with changes in cigarette design.

Today, I want to note that the conclusions of Dr. Burns' study -- taken on face value as accurate -- indicate that Philip Morris should be congratulated for having produced a safer cigarette. The Associated Press article, which appeared in the Sacramento Bee, reveals that Philip Morris has succeeded in developing cigarettes with lower levels of nitrosamines. According to the article: "Philip Morris, which supports FDA tobacco regulation, began taking steps with its growers in 2000 that have yielded "significantly lower" nitrosamine levels in recent years' supplies, Sutton [a Philip Morris spokesman] said."

If we accept Dr. Burns' argument, then we must also accept that Philip Morris, by reducing nitrosamine levels in its cigarettes, is reducing lung cancer risk for its smokers and saving lives. We should also accept that Philip Morris has produced a safer cigarette. And we should allow Philip Morris to communicate to consumers that its cigarettes are now safer by virtue of their reduced levels of nitrosamines.

Unfortunately, it just isn't that simple. We just are not able to draw simple conclusions about the relationship between cigarette constituent yield and disease risk, like Dr. Burns has done in his "study." As another tobacco control expert - Dr. Neal Benowitz - is quoted as saying in the same article: "Be careful in assuming lower-nitrosamine cigarettes are less lethal."

The whole point is that we cannot make the assumption that reducing the yield of particular constituents in cigarettes results in a safer cigarette. With the case of low-yield cigarettes, that has clearly not been the case. In fact, as Dr. Burns himself acknowledges, the lung cancer risk of these low-yield cigarettes is actually higher.

Falling into this trap does a disservice to the American public because it leads consumers to believe that cigarettes will be safer when they actually are not. They could even be more dangerous. The FDA legislation essentially makes smokers guinea pigs to try out different ideas about changing the cigarette design but without knowing what the effect will be. But consumers will naturally assume that by virtue of the FDA requiring these changes, cigarettes must be safer.

In other words, the FDA legislation is one big scam. Smokers, and the protection of the public's health, are the big losers. Philip Morris is the big winner.

There's no question that Philip Morris should be congratulated. But not for creating safer, lower-nitrosamine cigarettes. What they should be congratulated for is having the brilliance to correctly guess that if they threw the prospect of weak FDA regulation of tobacco products out in front of the Campaign for Tobacco-Free Kids, the Campaign would bite. Philip Morris must have known that the Campaign would be enticed by the prospect for a pyrrhic victory. After all, being perceived as a victor seems to be the utmost concern of this self-important organization. Even if it comes at the expense of the long-term future of tobacco control and public health and the long-term institutionalization of conventional tobacco products into our societal infrastructure.

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About Me

Dr. Siegel is a Professor in the Department of Community Health Sciences, Boston University School of Public Health. He has 32 years of experience in the field of tobacco control. He previously spent two years working at the Office on Smoking and Health at CDC, where he conducted research on secondhand smoke and cigarette advertising. He has published nearly 70 papers related to tobacco. He testified in the landmark Engle lawsuit against the tobacco companies, which resulted in an unprecedented $145 billion verdict against the industry. He teaches social and behavioral sciences, mass communication and public health, and public health advocacy in the Masters of Public Health program.